Individual
KRANEISHA RENEE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
4330 E UNIVERSITY DR, MESA, AZ 85205-7004
(480) 296-3546
Mailing address
2022 N NAVADA ST, 1213, CHANDLER, AZ 85226
(480) 487-9098
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LAC17711
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LAC17711
LAC
AZ
Enumeration date
11/10/2020
Last updated
11/10/2020
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